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Amazonas

Crash of an Embraer EMB-110P1 Bandeirante near Manacapuru: 12 killed

Date & Time: Jul 29, 1998 at 1300 LT
Registration:
PT-LGN
Flight Phase:
Survivors:
Yes
Schedule:
Manaus – Tefé
MSN:
110-343
YOM:
1982
Country:
Crew on board:
3
Crew fatalities:
Pax on board:
24
Pax fatalities:
Other fatalities:
Total fatalities:
12
Captain / Total flying hours:
15000
Captain / Total hours on type:
8000.00
Copilot / Total flying hours:
2500
Copilot / Total hours on type:
2000
Circumstances:
The EMB-110 Bandeirante operated on a domestic flight from Manaus to Tefé, Brazil. Although the airplane was certificated for a maximum of 19 passengers, there were 25 passengers on board. Also, for financial reasons the crew decided to take more fuel than necessary for this flight. This resulted in the airplane departing with an excess of weight of 852 kg. About 20 minutes into the flight the oil pressure of the no. 2 engine dropped. The crew reduced engine power to 72% and continued to Tefé. When the flight was 185 km from Manaus at FL85 the oil pressure dropped to 40psi and the TGT increased. The copilot shut down the engine and the captain turned the airplane around, back to Manaus. At 13:15 the crew contacted Manaus ACC reporting that they were returning on one engine. The overloaded airplane flying on one engine, began to lose height. During the descent the speed was kept around 105 kts which occasionally caused activated stick shaker. To lose weight, the left overwing exit was opened and luggage of the passengers was jettisoned. The airplane did not make it to Manaus and an emergency landing on the Manacapuru River was made. The Bandeirante landed hard on the water, causing an opening in the fuselage. It sank quickly.
Probable cause:
The following factors were identified:
- It was not possible to examine the debris of the aircraft to determine the contribution of this factor to the failure of the left engine.
- It is possible that the failure to carry out a type B2 inspection and/or to carry out a type A1 inspection by an unqualified person may have contributed to the occurrence of a low oil pressure emergency, due to material deterioration or inadequate services. The impossibility of examining the aircraft could not determine this aspect.
- The owner of the air taxi company participated due to lack of adequate supervision in the planning of operations, at the technical, operational and administrative levels. This deficiency can be characterized, among other things, by the owner of the company that allowed the aircraft to fly with the type B2 inspection expired; by the excessive amount of fuel, when refueling in Manaus; by the unreasonable number of people on board, causing the aircraft to fly with excess weight, and still, by the receipt of pilots' salary to be conditioned to the accomplishment of the fateful flight.
- Errors were made by the aircraft crew due to the improper use of the resources available in the cabin, intended for the operation of the aircraft, due to non-compliance with operational rules.
- There was a mistake made by the crew due to the inadequate preparation for the flight, assuming numerous failures, such as: the non conference, by the pilots, of the cargo and passengers manifest; the lack of the realization of a briefing and still, to accept an aircraft for a flight, being the same with its inspection not carried out.
- An error was made by the crew due to inadequate evaluation of certain aspects of the flight. Such deficiency was evidenced when the first sign of failure of the lubrication system occurred, after twenty minutes of flight, and even so, they decided to proceed with the flight, when the most sensible and safe would be the return, immediately, to Manaus.
- The airline's support staff participated in the planning of weight and balance of the aircraft and the number of passengers on board, providing incorrect information to the aircraft's crew members. In addition, the mechanic who performed the A1 type inspection was not qualified for the function.
- There has been intentional non-compliance by the crew members with the operational rules established by the aircraft manufacturer.
- The Commander did not foresee what was predictable, for lack of caution, thus intentionally increasing the risk margin of the mission.
Final Report:

Crash of a De Havilland C-115 Buffalo at Ponta Pelada AFB

Date & Time: May 15, 1995
Type of aircraft:
Operator:
Registration:
2361
Flight Type:
Survivors:
Yes
Schedule:
Ponta Pelada AFB - Ponta Pelada AFB
MSN:
31
YOM:
1969
Country:
Crew on board:
0
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Circumstances:
The crew was completing a local training flight at Ponta Pelada AFB, Manaus. Upon landing, the aircraft went out of control, veered off runway and came to rest few dozen metres further. There were no casualties while the aircraft was damaged beyond repair.

Crash of an Embraer EMB-110EJ Bandeirante in São Gabriel da Cachoeira

Date & Time: May 7, 1994 at 1248 LT
Operator:
Registration:
PT-GJW
Survivors:
Yes
Schedule:
Santa Isabel do Rio Negro – São Gabriel da Cachoeira
MSN:
110-072
YOM:
1976
Country:
Crew on board:
2
Crew fatalities:
Pax on board:
14
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
15000
Captain / Total hours on type:
5180.00
Circumstances:
The crew encountered poor weather conditions on approach to São Gabriel da Cachoeira Airport with low visibility due to fog. On short final, the crew failed to realize his altitude was insufficient when the aircraft collided with trees and crashed few hundred metres short of runway. All 16 occupants were injured, three seriously. The aircraft was destroyed.
Probable cause:
Contributing factors
a. Human Factor
(1). Psychological Aspect
It contributed, since the pilot in command adopted an improvisational attitude through the adoption of unforeseen procedures in the face of the insistence on landing, despite the weather conditions present. A likely channeling of attention to external references may have contributed to the loss of operational performance, leading to the loss of the maintenance condition of the basic flight parameters.
(2). Physiological Aspect
Undetermined since the absence of interference from toxicological factors was not effectively verified.
b. Material Factor
Didn't contribute.
c. Operational Factor
(1). Deficient Instruction
It contributed since there was no periodic simulator training and also no cockpit resource management (CRM) training.
(2). Deficient Supervision
It contributed since there was no adequate monitoring of the circumstances of operation by the Company's operations sector and, also, there were no defined and clear rules and specific operating routines that adequately addressed the various aspects of the operation.
(3). Little Flight or Aircraft Experience
It contributed because of the small experience in the aircraft by the copilot.
(4). Influence of the Environment
It contributed since visibility was limited at the time of the accident.
(5). Deficient Cockpit Coordination
Contributed since there was no briefing to the accomplishment of the descent procedure by instruments, the copilot did not follow the execution of the procedures after the critical point since he concentrated his attention to the search of external references, thus abandoning the monitoring of the flight parameters.
(6). Disabled Infrastructure
Indetermined since the influence of the low accuracy of the NDB on the heading lags occurred in the descent procedure was not perfectly established and no effective test was performed.
(7). Poor Planning
It contributed because there was no briefing in the procedure of descent by instrument and approach lost.
(8). Deficient discipline of Flight
The pilot therefore continued the flight, without visibility, at an altitude below the minimum for this operating condition.
(9). Adverse Weather Conditions
It contributed as the prevailing weather conditions were marginal, with the aerodrome closed for IFR operation.
Final Report:

Crash of a Boeing 707-365C in Manaus

Date & Time: Nov 26, 1992 at 0226 LT
Type of aircraft:
Operator:
Registration:
PT-TCP
Flight Type:
Survivors:
Yes
Schedule:
Manaus - Miami
MSN:
19416
YOM:
1967
Country:
Crew on board:
4
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Circumstances:
After liftoff from Manaus-Eduardo Gomes Airport runway 28, while in initial climb, the right main gear struck an element of the approach light system. An alarm sounded in the cockpit, informing the crew about landing gear problems. As the crew was unable to raise the landing gear, the captain informed ATC about the situation and was cleared to return for an emergency landing. Upon touchdown on runway 28, the right main gear collapsed. The aircraft slid for few dozen metres then veered off runway and came to rest in a ravine. All five occupants escaped uninjured while the aircraft was damaged beyond repair.
Probable cause:
It was reported that the crew adopted a wrong takeoff configuration and that the rate of climb and gradient were too low after takeoff (positive but insufficient vario), causing the aircraft to collide with an equipment of the approach light system.

Crash of a Beechcraft C90A King Air in Manaus: 7 killed

Date & Time: May 30, 1990 at 1500 LT
Type of aircraft:
Operator:
Registration:
N31434
Flight Type:
Survivors:
No
Schedule:
Pitinga - Manaus
MSN:
LJ-1186
YOM:
1988
Country:
Crew on board:
2
Crew fatalities:
Pax on board:
5
Pax fatalities:
Other fatalities:
Total fatalities:
7
Circumstances:
The approach to Manaus-Eduardo Gomes was completed in heavy rain falls. On short final, the crew failed to realize his altitude was too low when the aircraft struck an element of the approach light system and crashed 200 meters short of runway, bursting into flames. All seven occupants were killed.

Crash of an Embraer C-95 Bandeirante near Manaus: 1 killed

Date & Time: Jun 16, 1987 at 0745 LT
Type of aircraft:
Operator:
Registration:
2185
Flight Phase:
Flight Type:
Survivors:
Yes
Schedule:
Ponta Pelada – Boa Vista
MSN:
110-114
YOM:
1976
Location:
Country:
Crew on board:
2
Crew fatalities:
Pax on board:
7
Pax fatalities:
Other fatalities:
Total fatalities:
1
Circumstances:
Fifteen minutes after takeoff from Ponta Pelada AFB, en route to Boa Vista, one of the engine lost power. The crew elected to return but as he was unable to maintain a safe altitude, he attempted an emergency landing when the aircraft crashed onto a house. All nine occupants were injured and one people in the house was killed.
Probable cause:
Engine problems for unknown reasons.

Crash of a Boeing 707-330C in Manaus

Date & Time: Apr 11, 1987
Type of aircraft:
Operator:
Registration:
PT-TCO
Flight Type:
Survivors:
Yes
MSN:
18932
YOM:
1966
Country:
Crew on board:
3
Crew fatalities:
Pax on board:
4
Pax fatalities:
Other fatalities:
Total fatalities:
0
Circumstances:
The approach to Manaus-Eduardo Gomes Airport was completed in poor weather conditions with limited visibility due to heavy rain falls. On final, the crew failed to realize that the airplane was not properly aligned with the runway centerline. The aircraft landed to the right of the centerline, causing the right main gear to collapse after it struck runway lights and an electric box. The aircraft slid for few hundred meters before coming to rest. All seven occupants escaped uninjured.

Crash of a Boeing 737-2A1C in Manaus: 2 killed

Date & Time: Feb 22, 1983
Type of aircraft:
Operator:
Registration:
PP-SNC
Flight Phase:
Flight Type:
Survivors:
No
Schedule:
Manaus - Manaus
MSN:
21187
YOM:
1975
Country:
Crew on board:
2
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
2
Circumstances:
The crew (one pilot and one instructor) was engaged in a local training flight at Manaus-Eduardo Gomes Airport. After a simulated asymmetrical power takeoff, the airplane encountered difficulties to gain sufficient height. The crew increased engine power but the airplane stalled and crashed in a wooded area located few km from the airfield, bursting into flames. Both pilots were killed. It is believed that the aircraft was on its way to São Paulo Airport, carrying a load of televisions.
Probable cause:
The accident was the consequence of the combination of the following findings:
- Poor flight preparation,
- Lack of crew coordination,
- Failure to follow pre-takeoff procedures,
- Inadequate supervision on part of the instructor.

Crash of a Fairchild-Hiller FH-227B in Tabatinga: 44 killed

Date & Time: Jun 12, 1982 at 0605 LT
Type of aircraft:
Operator:
Registration:
PT-LBV
Survivors:
No
Schedule:
Eirunepé - Tabatinga
MSN:
536
YOM:
1967
Country:
Crew on board:
4
Crew fatalities:
Pax on board:
40
Pax fatalities:
Other fatalities:
Total fatalities:
44
Circumstances:
The approach to Tabatinga Airport was initiated by night and poor weather conditions. On final, the aircraft was too low and struck a pole. It lost height and crashed, bursting into flames. The aircraft was destroyed and all 44 occupants were killed.
Probable cause:
It was determined that at the time of the accident, the visibility was low due poor weather conditions. Due to a general electrical failure, the approach lights and runway lights were not functioning and the airport was not equipped with an emergency generator. Due to pressure caused by bad weather and the fact that the aircraft was short of fuel, the crew decided to attempt a visual approach in such conditions instead of diverting to the nearest airport of Leticia.

Crash of a Boeing 707-341C in Manaus

Date & Time: Jun 11, 1981
Type of aircraft:
Operator:
Registration:
PP-VJT
Flight Type:
Survivors:
Yes
MSN:
19322
YOM:
1967
Country:
Crew on board:
3
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Circumstances:
After touchdown on a wet runway at Manaus-Eduardo Gomes Airport, the four engine airplane deviated to the right, causing the right main gear to struck runway lights. Upon impact, the right main gear was torn off and the airplane came to rest. All three crew members escaped uninjured while the aircraft was damaged beyond repair. It was reported that the crew landed at an excessive speed of 148 knots on a wet runway due to heavy rain falls. It may be possible that the aircraft suffered aquaplaning after touchdown.